Provider Demographics
NPI:1265905525
Name:TIRADO-COSTACAMPS, CINTHIA LORRAINE (CHES)
Entity type:Individual
Prefix:
First Name:CINTHIA
Middle Name:LORRAINE
Last Name:TIRADO-COSTACAMPS
Suffix:
Gender:F
Credentials:CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 CALLE FLORIDA
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-3471
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:217 CALLE FLORIDA
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-3471
Practice Address - Country:US
Practice Address - Phone:787-629-3987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR26892174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator